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Comparing rates of retinal nerve fibre layer loss with GDxECC using different methods of visual-field progression
  1. Dilraj S Grewal1,
  2. Mitra Sehi1,
  3. David S Greenfield1,
  4. The Advanced Imaging in Glaucoma Study Group1,2,3
  1. 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Palm Beach Gardens, Florida, USA
  2. 2Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  3. 3Department of Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
  1. Correspondence to Dr Mitra Sehi, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 7101 Fairway Drive, Palm Beach Gardens, FL 33418, USA; msehi{at}med.miami.edu

Abstract

Background This prospective analysis was designed to examine the rate of RNFL loss using scanning laser polarimetry (GDx enhanced corneal compensation (GDxECC)) in progressing versus non-progressing eyes using various methods to define functional progression.

Methods Glaucoma suspect and glaucomatous eyes with ≥3 years of follow-up participating in the Advanced Imaging for Glaucoma Study were enrolled. All eyes underwent standard automated perimetry (SAP) and GDxECC imaging every 6 months. The annual rate of RNFL loss with GDxECC was calculated using linear regression analysis. Functional progression was determined using the Early Manifest Glaucoma Trial (EMGT) criterion, SAP Visual Field Index (VFI) and Progressor software.

Results Fifty-three eyes (30 glaucoma suspect, 23 glaucoma) of 53 patients (mean age 64.5±10.7 years, range 42–79) were enrolled. Eighteen eyes (40%) demonstrated SAP progression during the follow-up period using the Progressor criterion, 10 eyes (18.9%) using the VFI criterion, and 3 eyes (5.7%) using the EMGT criterion. The annual rate (μm/year) of mean RNFL loss was significantly greater (p<0.05) in progressing versus non-progressing eyes using Progressor (−1.24±0.99 vs −0.18±0.49), EMGT (−1.95±0.99 vs −0.46±0.78) and VFI (−1.11±0.64 vs −0.41±0.85) criteria.

Conclusion Despite differences in the criteria used to judge functional progression, progressing eyes have a significantly greater rate of RNFL loss measured using GDxECC as compared with non-progressing eyes.

  • Glaucoma
  • retinal nerve fibre layer
  • glaucoma progression
  • visual-field progression
  • scanning laser polarimetry
  • optic nerve
  • intraocular pressure
  • imaging
  • field of vision

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Footnotes

  • Meeting presentation: Presented in part at the annual meeting of the American Glaucoma Society, Naples, Florida, 6 March 2010.

  • The Advanced Imaging for Glaucoma Study Group: See http://www.aigstudy.net for the full list of authors.

  • Funding NIH Grants RO1-EY013516, Bethesda, Maryland, an unrestricted grant from Research to Prevent Blindness P30-EY14801, New York.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the University of Miami Miller School of Medicine.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • The Advanced Imaging for Glaucoma Study Group: University of Miami, Bascom Palmer Eye Institute, Palm Beach, Florida: DS Greenfield, CD Quinn, K Kishor, M Sehi and DS Grewal. University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania: JS Schuman, RJ Noecker, H Ishikawa, G Wollstein, RA Billonick and L Kagemann. University of Southern California Keck School of Medicine, Doheny Eye Institute, Los Angeles, California: D Huang, R Varma, V Chopra, B Francis, F Memarzadeh, KL Lu, O Tan and SR Sadda.

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